SAQ 106 – Trauma – penetrating neck injury

Question 3. penetrating neck injury.

a. Important historical features

• Type of weapon, such as knife versus other implement.
• Weapon features including length, width, and blade edge.
• Estimated blood loss at the scene.
• Symptoms suggesting airway compromise, such as stridor.
• Symptoms suggesting breathing compromise, such as shortness of breath.
• Neurological or circulatory symptoms such as focal neurological deficit.
• Other sites of injury or blows.

b. Important examination features

• Vital signs and haemodynamic stability.
• Airway threat such as stridor or expanding haematoma.
• Breathing threat such as pneumothorax, tension pneumothorax, marked respiratory distress, subcutaneous emphysema, or air bubbling through the wound.
• Circulatory findings including active bleeding or haematoma.
• Site of wound and neck zone involved.

c. Neck zone boundaries

• Zone 1: clavicles to inferior border of the cricoid cartilage.
• Zone 2: inferior border of the cricoid cartilage to angle of the mandible.
• Zone 3: angle of the mandible to base of skull.

d. ED repair feature

• Platysma is not breached.